CT三维重建成象用于髋部病变诊断的临床价值

目的 探讨螺旋CT三维重建成象在髋部骨折、脱位、退变、股骨头无菌性坏死等病变诊断中的临床应用价值。方法 对40例部病变患者进行螺旋CT三维重建成象并进行分析，观察病变的立体形态及其与周围结构的关系，并与常规X线片及CT二维成象结果进行比较。结果 髋关节骨折脱位26例，退变性关节炎8例，股骨头无菌性坯 锴6例。常规X线片能显示骨折脱位，但有漏诊且难以确定骨折类型，对退变性髋关节炎、股骨头无菌性坏死的影像显示结构重叠；CT二维成象可明显髋部病变的具体影像学改变，降低髋部骨折的漏诊率并明显骨折类型，但需有丰富的阅片经验；CT三维重民象可以得到髋部骨折、脱位、股骨头塌陷等病变最全面、直观的图像。结论 常规X线片诊断髋部病变的影像显示有限；CT二维成象能显示髋部病变的具体影像学改革，可降低漏诊率：CT三维重建成象是二维成象的重要补充，能直观显示病变的立体形态，尤能明确复杂骨折的移位和粉碎程度，并指导手术入路和内固定。

Clinical significance of 3-D computed tomography in diagnosing hip diseases

Objective To investigate the clinical significance of spiral CT in diagnosing hip fracture and dislocation,degenerative disease and aseptic necrosis of the fermoral head.Methods Three_dimensional image reconstruction of 40 cases of hip diseases were performed with use of spiral CT,the solid shape of the lesion and surrounding structures were observed,and compared to the results by 2_dimensional CT image.Results There were 26 cases of hip fractures and dislocations,8 degenerative arthritis and 6 aseptic necrosis of the femoral head.Plain radiograph and 2_dimensional CT imaging could not produce clear and comprehensive image of hip fracture and dislocation or femoral head collapse as spiral CT did.Conclusions Three_dimensional image reconstruction with use of spiral CT has definite advantages in reproducing clear images of the hip lesions and facilitating the diagnosing process,aiding in selection of surgical approach and internal fixation according to the severity of hip fracture and dislocation.